Addressing domestic violence through maternity services: policy and practice

Objective: to explore current policies and practices in maternity units that aim to identify, assess and support women experiencing domestic violence. Design and setting: a postal survey, conducted between June and October 1999, of all NHS Trusts in England and Wales that provided maternity services. Participants: Heads of Midwifery or the midwife with expertise or interest in domestic violence in each Trust. Main outcome measures: use of written policies and agreed practices for identifying and referring women experiencing domestic violence, such as availability of information, routine questioning of all women and offering women an appointment without their partner. Results:87% (183) of the 211 NHS Trusts providing maternity care participated in the survey. Twelve per cent of units had written policies for identifying women experiencing domestic violence, and a further 30% had some form of agreed practice. Less than half of maternity units routinely offered women an appointment without their partner, and just over half displayed material about domestic violence in places where women receive maternity care. Only three units had undertaken audit on their domestic violence practices. Conclusions: there is considerable variability around England and Wales in policies and practices related to domestic violence. It is evident that clear guidelines for identification and referral, training, audit and the integration of domestic violence policies with child protection and other policies are necessary to fully address the issues.